Diagnostic Testing

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Diagnostic testing for thoracolumbar conditions is similar to that for the cervical spine. Plain radiographs (AP, lateral, and oblique views) can be obtained (Fig. 31-15). CT, MRI, or myelography may be indicated in patients with worsening neurologic deficits or a suspected systemic cause of back pain, such as infection or neoplasm. These imaging studies are also useful when referral for surgery is considered.

Table 31-2 Normal Range of Movement: Thoracolumbar Spine

Motion

Range

Flexion

0-80 degrees

Extension

0-20 degrees

Lateral bend

0-35 degrees

Rotation

0-45 degrees

Modified from Carr AJ, Harnden A. Orthopedics in Primary Care. Newton, Mass, Butterworth-Heinemann, 1997.

Figure 31-13 Bowstring sign. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 365.)
Figure 31-14 Femoral nerve stretch test. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 367.)

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